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Amivantamab infusion

Updated 2 Feb 2023 | Amivantamab


Concentrate for solution for intravenous infusion containing amivantamab.

These products have been produced by recombinant technology using Chinese Hamster Ovary (CHO) cell lines.

Drugs List

  • amivantamab 350mg/7ml concentrate for solution for infusion vial
  • RYBREVANT 350mg/7ml concentrate for solution for infusion vial
  • Therapeutic Indications


    Maintenance monotherapy of advanced / metastatic non-small cell lung cancer

    Amivantamab is indicated as a monotherapy in the treatment of adults with advanced or metastatic non-small cell lung cancer, with activating epidermal growth receptor Exon 20 insertion mutations and whose disease has advanced during or following platinum-based chemotherapy.


    Due to the complexity and specialist nature of dosage regimens for the treatment of malignant disease, specific dosing information on this agent is not included.

    Doses may vary significantly if this agent is used as monotherapy or different combinations.
    When using this agent, specialist literature, national guidelines, cancer network protocols and Trust chemotherapy protocols should be consulted.

    Pre-medication consisting of an anti-pyretic and/or antihistamine should always be administered before each infusion. Pre-medication with corticosteroids should also be considered when these do not form part of the chemotherapy regime.

    Additional Dosage Information

    Infusion-related reaction
    Grade 1 to 3: Interrupt infusion. Additional medications such as glucocorticoids, antihistamine, antipyretics and antiemetics, should be administered. Upon symptom relief, resume infusion at 50% of the previous rate. Infusion rate may then be increased per the recommended infusion rate if there are no additional symptoms.
    Recurrent Grade 3 or Grade 4: Permanently discontinue.

    Interstitial Lung Disease (ILD)/Pneumonitis
    Suspected ILD/pneumonitis: Interrupt treatment.
    Confirmed ILD/pneumonitis: Permanently discontinue treatment.

    Skin and nail reactions
    Grade 2: Initiate supportive care. If not resolution after 2 weeks, consider dose reduction.
    Grade 3: Initiate supportive care. Interrupt treatment until adverse reaction improves. Upon recovery to Grade 2 or below, treatment may resume at a lower dose. If no improvement within 2 weeks, treatment must be permanently discontinued.
    Grade 4: Permanently discontinue.

    Other adverse reactions
    Grade 3: Interrupt treatment until the adverse reaction improves to Grade 1 or below, or returns to baseline. If recovery occurs within 7 days, treatment may resume at the same dose. If recovery occurs after 7 days, treatment may resume at a reduced dose. If recovery does not occur within 4 weeks, permanently discontinue treatment.
    Grade 4: Interrupt treatment until the adverse reaction improves to Grade 1 or below, or returns to baseline. If recovery occurs within 7 days, treatment may resume at the same dose. If recovery occurs after 7 days, consider permanently discontinuing treatment. In the event of recurrent Grade 4 reactions, treatment must be permanently discontinued.

    Dose reductions for adverse reactions
    Body weight below 80kg
    Initial dose: 1050mg
    1st dose reduction: 700mg
    2nd dose reduction: 350mg
    3rd dose reduction: Discontinuation of amivantamab

    Body weight 80kg or above
    Initial dose: 1400mg
    1st dose reduction: 1050mg
    2nd dose reduction: 700mg
    3rd dose reduction: Discontinuation of amivantamab


    Amivantamab is to administered by intravenous infusion via a dedicated line.


    Children under 18 years

    Precautions and Warnings

    Moderate hepatic impairment
    Severe renal impairment

    Advise ability to drive/operate machinery may be affected by side effects
    Consider pre-medication with antihistamines and/or antipyretics
    Consider premedication with a corticosteroid
    Consider use of corticosteroids if adverse reactions occur
    Treatment to be initiated and supervised by a specialist
    Contains polysorbate
    Concentrate must be diluted and used as an infusion
    Consult local policy on the safe use of anti-cancer drugs
    Interrupt treatment if infusion reaction occurs & monitor until resolution
    Record name and batch number of administered product
    Staff: Not to be handled by pregnant staff
    Monitor patient for infusion-associated reactions (IARs)
    Consider the use of anti-emetics before and during therapy
    Discontinue treatment if interstitial lung disease develops
    Suspend treatment if grade 3 or worse skin reaction occurs
    Suspend treatment if pneumonitis is suspected
    Discontinue if grade 3 or greater adverse reaction that recurs/persists
    Discontinue if grade 4 skin reaction occurs
    Discontinue if treatment related pneumonitis is diagnosed
    Suspend treatment if grade 3 or greater adverse reaction occurs
    Suspend treatment if interstitial lung disease is suspected
    Female: Contraception required during and for 3 months after treatment
    Breastfeeding: Do not breastfeed during & for 3 months after treatment
    Advise patient on appropriate sun protection methods
    Advise patient to limit sun exposure during & for 2 months after treatment

    Prior to treatment with amivantamab, the status of EGR Exon 20 insertion mutations should be established by an experienced laboratory.

    Pregnancy and Lactation


    Amivantamab is contraindicated during pregnancy.

    Use of amivantamab during pregnancy is contraindicated by the manufacturer. At the time of writing there is limited published information regarding the use of amivantamab during pregnancy. However, administration of EGFR and MET inhibitors in pregnant animals has resulted in teratogenic effects. Therefore, potential risks in human pregnancy cannot be ruled out.


    Amivantamab is contraindicated in breastfeeding.

    Use of amivantamab when breastfeeding is contraindicated by the manufacturer due to the risk of serious adverse reactions in breast-fed infants. The presence of penicillin in human breast milk is unknown. Effects on exposed infants are unknown.

    Breastfeeding must be discontinued during treatment and for 3 months after. All breast milk expressed during this period should be discarded.

    Side Effects

    Abdominal pain
    Alanine aminotransferase increased
    Aphthous ulcers
    Aspartate aminotransferase increased
    Back pain
    Chest discomfort
    Decreased appetite
    Dermatitis acneiform
    Dry skin
    Eye disorder
    Eyelash growth
    Increase in serum alkaline phosphatase (reversible)
    Infusion related reaction
    Interstitial lung disease
    Muscle weakness
    Nail disorders
    Peripheral oedema
    Pleural effusion
    Pulmonary embolism
    Toxic epidermal necrolysis
    Visual disturbances


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: January 2022

    Reference Sources

    Summary of Product Characteristics: Rybrevant (amivantamab) 50mg/mL concentrate for solution for infusion. Janssen-Cilag Ltd. Revised November 2021.

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    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

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    FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.